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General NPI Number Information
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NPI Number | 1992162119
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Entity Type | Organization
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Legal Business Name | ROSE BLOSSOM CARE
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Dates
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Enumeration Date | 01/19/2016
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 25819 AMAPOLAS ST
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City | LOMA LINDA
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State | CA
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Zip | 92354-2503
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Country | US
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Telephone | 909-480-5909
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Fax |
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Provider Business Mailing Address
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Address Line | 26140 WINDSOR DR
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City | LOMA LINDA
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State | CA
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Zip | 92354-4100
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Country | US
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Telephone | 909-480-5909
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MOIRA RAI
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Credential |
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Telephone | 909-480-5909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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